Provider Demographics
NPI:1346459302
Name:ESCAPE MASSAGE THERAPY
Entity Type:Organization
Organization Name:ESCAPE MASSAGE THERAPY
Other - Org Name:ESCAPE BODY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:LMP
Authorized Official - Phone:360-944-6692
Mailing Address - Street 1:120 NE 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5020
Mailing Address - Country:US
Mailing Address - Phone:360-944-6692
Mailing Address - Fax:360-944-7732
Practice Address - Street 1:120 NE 117TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5020
Practice Address - Country:US
Practice Address - Phone:360-944-6692
Practice Address - Fax:360-944-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034699111N00000X
WAAC00000759171100000X
WAPT00010320225100000X
WAMA00016616225700000X
WAMA00017876225700000X
WAMA00023440225700000X
WAMA00019889225700000X
WAMA00016050225700000X
WAMA00018153225700000X
WAMA00022035225700000X
WAMA00023428225700000X
WAMA00018303225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty